Influenza Exposure  

This Care Guide Covers:

  • Exposure (Close Contact) to a person with influenza
  • Questions about influenza
  • Your child has NO symptoms of influenza (no fever, cough, sore throat, runny nose)
  • For children with symptoms of influenza, see the Influenza care guide.

If not, see these topics

Close contact with Influenza within last 7 days AND cough with fever. See INFLUENZA.

When to Call Your Doctor

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • Influenza Close Contact within last 7 days AND your child is HIGH-RISK. See the list of children at High-Risk for complications of flu.
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Age over 6 months and needs a flu shot
Parent Care at Home If
  • Influenza Questions and NO Close Contact in the last 7 days
  • Influenza Prevention Questions
  • Tamiflu Prescription Questions
  • Influenza Close Contact within the last 7 days , but LOW-RISK child
  • Influenza Minor Contact (same school or gathering) BUT No Close Contact
Causes & Health Information

Exposure (Close Contact) Definition:.

  • Household Close Contact. Lives with a person with flu.
  • Other Close Contact. Touching distance within 3 feet (1 meter) of person with flu. Close contact includes kissing, hugging or sharing eating and drinking utensils. It also includes close conversations. Direct contact with secretions of a person with flu is also close contact. Includes being in the same child care center room or carpool.
  • Not Close Contact - In same building. Walking by a person or sitting in a room briefly is not close contact. Being in the same school, church, workplace or building also is not close contact.
  • Not Close Contact - In same town. Living in a town where there are people with the flu is not close contact. Living in the same state or country (such as Mexico) carries no added risk.

HIGH-RISK Children for Complications From Influenza (AAP)

Children are considered HIGH-RISK for complications if they have any of the following:

  • Lung disease (such as asthma)
  • Heart disease (such as a congenital heart disease)
  • Cancer or weak immune system conditions
  • Neuromuscular disease (such as muscular dystrophy)
  • Diabetes, sickle cell disease, kidney disease OR liver disease
  • Diseases requiring long-term aspirin therapy
  • Pregnancy
  • All healthy children under 2 years old are also considered HIGH-RISK (CDC 2009)
  • Note: All other children are referred to as LOW-RISK

Prescription Antiviral Drugs for Influenza

  • Antiviral drugs (such as Tamiflu) are sometimes used to treat influenza. They must be started within 48 hours of when flu symptoms start.
  • The AAP recommends they be used for any patient with severe symptoms. They also recommend the drugs for most HIGH-RISK children. See that list.
  • The AAP doesn't recommend antiviral drugs for LOW-RISK children with mild flu symptoms.
  • Their benefits are limited. They usually reduce the time your child is sick by 1 to 1.5 days. They reduce the symptoms, but do not make them go away.
  • Side effects: Vomiting in 10% of children.
CARE ADVICE FOR INFLUENZA EXPOSURE

Influenza Questions and NO Close Contact in the last 7 days
  1. What You Should Know:
    • For most healthy people, the symptoms of influenza are like those of a common cold.
    • But, with flu, the onset is more abrupt. The symptoms are more severe.
    • Feeling very sick for the first 3 days is common.
    • The treatment of influenza depends on your child's main symptoms. It is no different from treatment used for other viral colds and coughs.
  2. Influenza Symptoms:
    • The main symptoms are fever, cough, sore throat and runny nose.
    • Most often, fever is present. (Exception: Sometimes, no fever if the child has a weak immune system.)
    • Other common symptoms are muscle pain, headache and fatigue.
    • Some people also have vomiting and diarrhea, but never as the only symptom.
  3. Influenza Diagnosis and Flu Tests:
    • During influenza season, if your child has flu symptoms, he probably has the flu.
    • Your child doesn't need any special tests.
    • You should call your doctor if your child is HIGH-RISK for complications of flu. These are children with chronic diseases. Examples of such diseases are asthma or a weak immune system. See the HIGH-RISK list. Also, healthy children under 2 years of age are HIGH-RISK.
    • For LOW-RISK children, you don't need to see your child's doctor.
    • If your child develops a complication of the flu, then call your child's doctor. Examples of complications are an earache or trouble breathing. These problems are included in the "When to Call Your Doctor" section.
  4. Influenza Treatment:
    • Tamiflu is the main antiviral drug used to treat influenza in children.
    • The AAP recommends it be used for any patient with severe symptoms. They also recommend the drug for most HIGH-RISK children. See that list. Mainly, it is used for children in the hospital or those with chronic diseases.
    • Treatment is not recommended for LOW-RISK children with normal flu symptoms. (AAP)
    • Most patients recover without taking Tamiflu.
  5. Return to School:
    • Spread is rapid and the virus is easily passed to others. The time it takes to get the flu after contact is about 2 days. The range is 1-4 days.
    • Your child can return to school after the fever is gone. (CDC 2009).
    • The influenza virus is spread in the air from sneezing and coughing.
    • It also can be spread by the hands with flu germs on them.
  6. What to Expect:
    • The fever lasts 2 -3 days.
    • The runny nose lasts 1-2 weeks.
    • The cough lasts 2-3 weeks.
  7. Call Your Doctor If:
    • You have other questions or concerns
Influenza Prevention Questions
  1. How to Protect Yourself From Getting Sick:
    • Wash hands often with soap and water.
    • Alcohol-based hand cleaners work very well.
    • Avoid touching the eyes, nose or mouth. Germs on the hands can spread this way.
    • Try to avoid close contact with sick people.
    • Avoid ERs and urgent care clinics if you don't need to go. These are places where you are more likely to be exposed to flu.
  2. How To Protect Others - Stay Home When Sick:
    • Cover the nose and mouth with a tissue when coughing or sneezing.
    • Wash hands often with soap and water. After coughing or sneezing are important times. Alcohol-based hand cleaners also work well.
    • Limit contact with others to avoid getting them sick.
    • Stay home from school or work while sick with fever. Your child can return to school after the fever is gone for 24 hours. (CDC 2009).
  3. Flu Shot:
    • Getting a flu shot is the best way to protect your family from flu.
    • Yearly influenza vaccines are strongly advised for all children over 6 months of age. (AAP)
    • Adults should also get the shot.
    • The flu shot most often prevents the disease.
    • Even if your child gets the flu, the shot helps to reduce the symptoms.
  4. Anti-Viral Medication:
    • Tamiflu can be used to prevent the flu. It may be prescribed after close contact with a person who has flu.
    • But, it is only advised for HIGH-RISK patients (CDC). See that list.
  5. Call Your Doctor If:
    • You have other questions or concerns
Tamiflu Prescription Questions
  1. Treating Influenza - Tamiflu:
    • Tamiflu is a prescription anti-viral drug. It is helpful in treating the flu virus.
    • The benefits are limited. Tamiflu reduces the time your child is sick by 1 to 1.5 days. It helps reduce the symptoms, but does not make them go away.
    • For best results, these drugs should be started within 48 hours of flu symptoms.
    • When to Use: Severe symptoms OR underlying health problems (HIGH-RISK group)
    • For HIGH-RISK children, call your child's doctor at the start of flu symptoms.
    • Most healthy patients have mild to moderate symptoms. Tamiflu treatment is not needed for these patients.
    • Tamiflu also has side effects. It causes vomiting in 10% of children.
  2. Preventing Influenza - Tamiflu:
    • The drug Tamiflu may help prevent flu.
    • It may be prescribed after close contact with a person who has flu.
    • But, it is only advised for HIGH-RISK patients (CDC). The HIGH-RISK group includes chronic diseases. It also includes children with health problems, such as heart or lung disease. See the HIGH-RISK list. It also includes healthy children under 2 years.
    • It is helpful only while your child is taking it. It won't prevent flu once your child stops taking it.
    • Your child should only take Tamiflu if your child's doctor advises it.
    • If a HIGH-RISK adult has close contact with flu, call their doctor. Do this within 24 hours. The HIGH-RISK adult group includes chronic disease, pregnant, or over 65. Reason: May need anti-viral medicine.
  3. Personal Stockpiling of Tamiflu - Not Advised:
    • Some people want a prescription for Tamiflu for all family members. They want it on hand just in case they come down with flu. They currently are well and have not been exposed to flu.
    • Doctors and the CDC are opposed to this practice. The AAP and your State's Public Health Department also do not support this.
    • The supply of Tamiflu is limited. It is used for those with severe symptoms OR who are HIGH-RISK.
  4. Call Your Doctor If:
    • You have other questions or concerns
Influenza Close Contact Within the Last 7 Days but LOW-RISK child
  1. What You Should Know:
    • Although your child was exposed to flu, your child does not have any symptoms.
    • Symptoms usually develop within 1-4 days of seasonal flu contact. 7 days is an outer limit.
    • Even if your child gets the flu, your child most likely will do fine. Anti-viral treatment (Tamiflu) is not needed for LOW-RISK children.
    • Healthy children get better from flu by treating the symptoms.
  2. Call Your Doctor If:
    • You have other questions or concerns
Influenza Minor Contact (same school) BUT NO Close Contact
  1. What You Should Know:
    • To catch influenza, your child needs to have close contact with an infected person.
    • Close contact includes kissing, hugging, or sharing eating or drinking utensils. It also includes close conversations within 3 feet (1 meter). Being in the same child care group or car pool is also close contact.
    • Being in the same school, church or building is not close contact.
    • If there was no close contact, your child probably will not get the flu.
    • Anti-viral medicine (Tamiflu) is not needed for LOW-RISK children.
    • Healthy children get better from flu by treating the symptoms.
  2. Call Your Doctor If:
    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.